Bada Yang, Robin W M Vernooij, Demy L Idema, Linde Huis In 't Veld, Mike P T Kusters, Rene Spijker, Kim van der Braak, Pauline Heus, Kevin Jenniskens, Lotty Hooft, Johanna A A Damen
{"title":"患者对预防发作性偏头痛的药物治疗的价值和偏好：美国医师学会的系统综述。","authors":"Bada Yang, Robin W M Vernooij, Demy L Idema, Linde Huis In 't Veld, Mike P T Kusters, Rene Spijker, Kim van der Braak, Pauline Heus, Kevin Jenniskens, Lotty Hooft, Johanna A A Damen","doi":"10.7326/ANNALS-24-00317","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Decision making regarding pharmacologic treatments for the prevention of episodic migraine may depend on the importance that patients place on outcomes and specific treatment preferences.</p><p><strong>Purpose: </strong>To assess patients' values and preferences regarding pharmacologic treatments for the prevention of episodic migraine.</p><p><strong>Data sources: </strong>MEDLINE and CINAHL from inception to April 2024.</p><p><strong>Study selection: </strong>Quantitative studies reporting on values and preferences regarding pharmacologic treatments for the prevention of migraine in adults were eligible.</p><p><strong>Data extraction: </strong>We extracted data on study design, participants, and findings and assessed risk of bias using a tool developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) working group.</p><p><strong>Data synthesis: </strong>We included 6 studies (5 discrete choice experiments and 1 survey) comprising a total of 2307 participants and assessing the importance of a total of 32 attributes. Risk of bias was moderate in 3 and low in 3 studies; all but 1 were industry spon sored. Migraine severity, frequency, and duration were found to be the most important among several outcomes including acute medication need and side effects (low certainty). Other outcomes of importance were migraine attack on day 1 postdosing (moderate certainty) and duration of daily activity limitations (high certainty). Patients preferred oral tablets to injections and infusions (moderate certainty).</p><p><strong>Limitations: </strong>Importance of attributes relative to each other could not be assessed due to the scarcity of direct comparisons. Participant sampling was unclearly reported in most studies.</p><p><strong>Conclusion: </strong>Patients may have the strongest preference for oral treatments that reduce the severity, frequency, and duration of their migraine attacks, which reduce the duration of daily activity limitations and reduce risk of migraine on day 1. Side effects may be less important.</p><p><strong>Primary funding source: </strong>American College of Physicians. (PROSPERO: CRD42023414305).</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"381-388"},"PeriodicalIF":19.6000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Patients' Values and Preferences Regarding Pharmacologic Treatments for the Prevention of Episodic Migraine Headache: A Systematic Review for the American College of Physicians.\",\"authors\":\"Bada Yang, Robin W M Vernooij, Demy L Idema, Linde Huis In 't Veld, Mike P T Kusters, Rene Spijker, Kim van der Braak, Pauline Heus, Kevin Jenniskens, Lotty Hooft, Johanna A A Damen\",\"doi\":\"10.7326/ANNALS-24-00317\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Decision making regarding pharmacologic treatments for the prevention of episodic migraine may depend on the importance that patients place on outcomes and specific treatment preferences.</p><p><strong>Purpose: </strong>To assess patients' values and preferences regarding pharmacologic treatments for the prevention of episodic migraine.</p><p><strong>Data sources: </strong>MEDLINE and CINAHL from inception to April 2024.</p><p><strong>Study selection: </strong>Quantitative studies reporting on values and preferences regarding pharmacologic treatments for the prevention of migraine in adults were eligible.</p><p><strong>Data extraction: </strong>We extracted data on study design, participants, and findings and assessed risk of bias using a tool developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) working group.</p><p><strong>Data synthesis: </strong>We included 6 studies (5 discrete choice experiments and 1 survey) comprising a total of 2307 participants and assessing the importance of a total of 32 attributes. Risk of bias was moderate in 3 and low in 3 studies; all but 1 were industry spon sored. Migraine severity, frequency, and duration were found to be the most important among several outcomes including acute medication need and side effects (low certainty). Other outcomes of importance were migraine attack on day 1 postdosing (moderate certainty) and duration of daily activity limitations (high certainty). Patients preferred oral tablets to injections and infusions (moderate certainty).</p><p><strong>Limitations: </strong>Importance of attributes relative to each other could not be assessed due to the scarcity of direct comparisons. Participant sampling was unclearly reported in most studies.</p><p><strong>Conclusion: </strong>Patients may have the strongest preference for oral treatments that reduce the severity, frequency, and duration of their migraine attacks, which reduce the duration of daily activity limitations and reduce risk of migraine on day 1. Side effects may be less important.</p><p><strong>Primary funding source: </strong>American College of Physicians. 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Patients' Values and Preferences Regarding Pharmacologic Treatments for the Prevention of Episodic Migraine Headache: A Systematic Review for the American College of Physicians.
Background: Decision making regarding pharmacologic treatments for the prevention of episodic migraine may depend on the importance that patients place on outcomes and specific treatment preferences.
Purpose: To assess patients' values and preferences regarding pharmacologic treatments for the prevention of episodic migraine.
Data sources: MEDLINE and CINAHL from inception to April 2024.
Study selection: Quantitative studies reporting on values and preferences regarding pharmacologic treatments for the prevention of migraine in adults were eligible.
Data extraction: We extracted data on study design, participants, and findings and assessed risk of bias using a tool developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) working group.
Data synthesis: We included 6 studies (5 discrete choice experiments and 1 survey) comprising a total of 2307 participants and assessing the importance of a total of 32 attributes. Risk of bias was moderate in 3 and low in 3 studies; all but 1 were industry spon sored. Migraine severity, frequency, and duration were found to be the most important among several outcomes including acute medication need and side effects (low certainty). Other outcomes of importance were migraine attack on day 1 postdosing (moderate certainty) and duration of daily activity limitations (high certainty). Patients preferred oral tablets to injections and infusions (moderate certainty).
Limitations: Importance of attributes relative to each other could not be assessed due to the scarcity of direct comparisons. Participant sampling was unclearly reported in most studies.
Conclusion: Patients may have the strongest preference for oral treatments that reduce the severity, frequency, and duration of their migraine attacks, which reduce the duration of daily activity limitations and reduce risk of migraine on day 1. Side effects may be less important.
Primary funding source: American College of Physicians. (PROSPERO: CRD42023414305).
期刊介绍：
Established in 1927 by the American College of Physicians (ACP), Annals of Internal Medicine is the premier internal medicine journal. Annals of Internal Medicine’s mission is to promote excellence in medicine, enable physicians and other health care professionals to be well informed members of the medical community and society, advance standards in the conduct and reporting of medical research, and contribute to improving the health of people worldwide. To achieve this mission, the journal publishes a wide variety of original research, review articles, practice guidelines, and commentary relevant to clinical practice, health care delivery, public health, health care policy, medical education, ethics, and research methodology. In addition, the journal publishes personal narratives that convey the feeling and the art of medicine.
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